The Uses and Misuses of In Vitro Fertilization in Israel: Some Sociological and Ethical Considerations

Israeli society has the highest rates of Assisted Reproductive Technologies (ART) intervention in the world, as well as the highest per capita consumption rate of infertility therapy, with In Vitro Fertilization (IVF) at its center. This situation is sustained by an unprecedented public health policy, posing hardly any restrictions on the eligibility of Israeli citizens for infertility treatments within the National Health Insurance (NHI) system. Given the health risks as well as the emotional and financial costs involved in the excessive use of IVF, this pattern of regulation and consumption calls for a careful sociological and ethical consideration of its origins and implications.

The paper is based on an analysis of key processes and events that took place in the Israeli regulatory and legal arena between 1994 (when the Israeli National Health Insurance Law was enacted) and 2003 (when the last attempt thus far to de-insure IVF was made). Processes and events that took place within that decade include legal actions taken by consumers in matters concerning IVF, court verdicts on IVF usage, parliamentary discussions on IVF regulation and failed attempts to restrict NHI coverage of IVF.

We argue that existing policies and utilization patterns of IVF in Israel are embedded within several frameworks: Israel's pro-natalist culture and "pro-family" values (both of which are contextualized within the Jewish state), a political discourse of demographic threats and rights, organizational changes stemming from the 1994 NHI Law, and the emergence of a "consumer rights" discourse within the public health system. In the concluding section, we discuss the ethical aspects of IVF in Israel, arguing that a reconsideration of priorities in a context of limited economic resources is much needed at this time.